N356Remark Code (RARC)Active
N356 Remark Code - Not Covered with Non-Covered Service
The N356 remark code indicates that the service billed is not covered because it was performed with, or following, a non-covered service. This means that the payer has determined that the service in question cannot be reimbursed due to its association with another service that is not eligible for coverage.
How It Relates to the Denial
The N356 remark code typically accompanies adjustment reason codes that indicate non-coverage or denial of a claim. The combination signals that the billed service is linked to a previously denied or non-covered service, impacting the payment decision.
Common Scenarios
1A provider billed for a follow-up visit after a non-covered procedure, such as a cosmetic surgery. The remittance shows a denial for the visit with the N356 remark code.
→ In this case, the N356 remark code suggests that the follow-up visit is not covered due to its relationship with the preceding non-covered procedure.
2A patient received therapy services immediately after a non-covered diagnostic test. The claim for the therapy services was denied with an adjustment reason code and the N356 remark code.
→ Here, the N356 remark code clarifies that the therapy is not eligible for coverage because it was performed in conjunction with a service that the payer does not cover.
3A claim for a lab test was submitted after a non-covered consultation. The remittance returned an adjustment reason code along with the N356 remark code.
→ The N356 remark code indicates that the lab test is not covered as it was performed subsequent to an already denied service.
What to Do
- Review the claim to identify the non-covered service linked to the billed service.
- Consider resubmitting the claim only if the non-covered service can be appealed or if additional documentation justifies the billed service's coverage.
What to Check
- The claim history to verify the non-covered service that triggered the N356 remark code.
- The adjustment reason code accompanying the N356 for additional context on the denial.
- The payer's policy on coverage related to services performed in conjunction with non-covered services.